Sensory and Autonomic Neuropathy and other symptoms

I've been experiencing paresthesias and stinging sensations in my legs and genitals - in sacral dermatomes in general. I also have some kind of problem with my urethral spinchter which doesn't have an anatomical cause due to my cystoscopy, so maybe that too has something to do with the nerves in that area? The elasticity and blood flow-regulation of my penis has also changed and most of the time it feels like constricted and hard somehow. I've also experienced the stinging sensations from my legs starting to radiate to my chest from where it radiates to my hand - it's clearly the same sensation i experience in my feet. There is also an electrical vibrating sensation around my heart / in my chest area and sometimes in my neck.

I've has an MRI done which was normal.

I've also experienced some genital rash that hasn't been confirmed as herpes - i've has 3 negative blood tests. The sensations in my legs started with the rash so it could be herpes and nerve inflammation that comes with it, but would herpes have such presentations as mine instead of just localised sensory neuropathy? Would it be possible that the herpes has infected from ganglia to other ganglia and now causes symptoms on a wider area?

I also started to have many vitreous opacities along the other symptoms - to my understanding vitreous opacities with neuropathies could be Lyme Disease, Sarcoidosis, Amyloidosis... I've also had negative Lyme test and many other negative blood tests.

So, i have:

- Sensory neuropathy in my sacral dermatome
- Possible autonomic neuropathy concerning urinary function and penile blood flow and maybe the heart in some way (the electrical vibration around it)
- Fatigue
- Vitreous opacities that appeared suddenly

What tests could be done to find out the cause? What could the cause be? Would it be useful to have Anti-ganglioside antibody test done?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Neuropathy is can lead to various sensory changes. The typical workup includes evaluating for diabetes, vitamin deficiences, autoimmune disorders (such as Sjogrens), neoplasm, toxins (such as lead). There are genetic and hereditary forms of neuropathy that may be found in family history. Typically, EMG/NCS is used to evaluate for neuropathy, but this test is only useful for large fibers. If it is an autonomic neuropathy, you may need testing such as a skin biopsy or QSART.

Have you had imaging of your lower back? It would be important to evaluate this area if not already done.

I do have to mention that often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.

These are just some causes of burning/tingling. Continued follow-up with your doctors is recommended. Evaluation by a neurologist, if you have not already done so, is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.